Colostomy Care
Colostomy is the opening of some portion of the colon onto the abdominal face
Reasons for Performing a Colostomy
- When feces cannot progress naturally from the colon to the anus
- When it is more desirable or manageable to divert the feces, as for paraplegics
- In any condition where the rectum or anus is nonfunctional because of disease, a birth defect or a traumatic condition.
- It is performed to divert the fecal flow away from an area of inflammation or around an operative area
General Procedure for Changing an Ostomy Pouch
Assessment
- Identify the type of ostomy the patient has and its location (Bowel Urinary Diversion)
- Assess the skin integrity around the stoma and as general appearance
- Note the amount and character of any fecal material or urine in the pouch
- Determine whether the patient is being taught self-care at the moment
Planning
- Wash your hands
- Gather the equipment needed in changing a pouch or dressing
- Cleansing supplies including tissues, warm water, mild soap, wash cloth and a towel
- Clean pouch of the type currently being used
- Seal or use tape to prevent leakage
- Clean belt
- Dressing materials
- Receptacle for the soiled pouch or dressing (bedpan, paper bag/newspaper for wrapping)
- Protective spray
- Clean gloves
- Determine whether the patient is to participate actively
- Choose the appropriate location in performing the procedure (bathroom/ bedside)
Implementation
- Identify the patient
- Explain the procedure to the patient
- Put on clean gloves for infection
- Assist the patient to the bathroom or provide privacy
- Remove the soiled dressing
- Using warm water and a mild soap, cleanse the skin around the stoma thoroughly. Inspect the skin for redness or irritation.
- Cover the stoma with a tissue to prevent feces or urine from contacting. Change tissues as necessary during the procedure
- Dry the skin around the stoma carefully, patting gently
- Apply a skin protective spray if needed
- Allow the skin to dry thoroughly so the pouch will adhere firmly (a hair dryer on a low setting at least 18 inches from the skin may be used)
- Remove the tissue from the stoma and apply the clean pouch or dressing
- Remove gloves and wash hands
Evaluation
- Evaluate using the following criteria
- Pouch or dressing secure
- Area clean
- Odor free
- Patient comfortable
- If the patient is being taught the procedure, add the following criteria:
- Patient is able to change pouch using correct technique
- Patient verbalizes understanding of key points in care
Documentation
- Record the following information:
- The amount, color, and consistency of the fecal material or urine in the pouch
- The application of the clean pouch and dressing change
- The knowledge and ability of the patient t participate in the procedure or ability to change independently.
